The term “mindfulness” is the English version of the word “sati” from the ancient Pali language of Buddhist scriptures, which can be translated as “full awareness,” “conscious attention,” or “aware mind.” It refers to the experience of a mental state: “the awareness that emerges through paying attention in a particular way: intentionally, in the present moment, and non-judgmentally” (Kabat-Zinn, 1994).
This mental state can be cultivated through a practice that originates from contemplative practices such as vipassana meditation, which is the oldest of Buddhist practices and is situated within the Theravada Buddhist tradition, born in South and Southeast Asia, in Thailand, Burma, Laos, Cambodia, and Sri Lanka, and has been used in both monastic and lay environments for more than 2,500 years.
Awareness meditation therefore refers to the possibility of acquiring profound knowledge through an act of perception not mediated by thoughts of the mind, capable of generating over time an intuitive, deep, and non-conceptual understanding of what is happening in the moment it happens. It is a mode of awareness based on refining attention to immediate experience with an attitude of openness and acceptance, and it promotes greater recognition of mental events in the present moment.
The therapeutic and liberating power of this state of mental presence is increasingly at the center of scientific interest and research in medicine, psychotherapy, and recently in psycho-social and educational fields.
Jon Kabat-Zinn, a molecular biologist-physician, is the recognized pioneer of clinical applications of mindfulness meditative practices. Since 1979, he has developed the Mindfulness-Based Stress Reduction (MBSR) program, the first clinical intervention protocol based on mindfulness. Since its inception, it has been completed by over 18,000 people and is offered in more than 400 hospitals in the United States and Europe within the context of integrative medicine. In 1995, he founded the Center for Mindfulness in Medicine, Health Care, and Society (CFM) in Boston, an institution that works on the development and dissemination of MBSR and, in general, on integrating mindfulness into the general practice of medicine and healthcare, as well as in other areas of society.
Mindfulness is therefore a “direct” way of knowing, through openness to whatever happens, moment by moment, in our lives. A way of being present and taking charge of one’s life, of doing for oneself what no one else can do for us: systematically bringing awareness to one’s stress, pain, illness, and to the challenges and pressing demands of daily life. An approach to awareness that can help us change our relationship with discomfort that, in different forms, we all experience.
Anyone who has experienced, in their existence, a state of psychological suffering and distress can easily understand, in fact, how much, in those moments, our mind is conditioned and distorted by a continuous, unconscious, and automatic succession of thoughts, moods, memories, expectations, and desires that do not concern the present moment we are living.
There is, therefore, a tendency to escape from the present to “pursue one’s aspirations and desires to be elsewhere, where we hope the situation is better, happier, as we would like it to be or as it once was” (Kabat-Zinn). In doing so, we forget to be “here” and to be “now,” we distance ourselves from the present moment, which is the only moment that actually exists, thus moving away from our internal experience at the moment we feel certain sensations and from the reality that surrounds us when we live certain experiences.
Mindfulness does not represent a technique to be learned to cope with suffering during a moment of difficulty. Nor does it constitute a modality through which to achieve a state of relaxation (an aspect more typical, for example, of autogenic training) or a form of trance that implies abandoning awareness. On the contrary, it is fundamentally based on increasing the state of awareness, enhancing the ability to stay in contact with oneself and with the present moment.
Meditation is “a living activity, entirely based on experience.
It cannot be taught as a purely academic subject.
The living heart of meditative practice must spring from personal experience.”
Henepola Gunaratana, Buddhist monk (1995)
Mindfulness practice is a way of inhabiting one’s person as an observer who lovingly watches their psychological landscape. This practice teaches how to be aware of oneself and the world around us; it enables one to perceive one’s limits and see them as a possibility rather than a limitation.
Cultivating this non-judgmental observation allows one to be more welcoming and patient in the face of adversity and pain. This approach today represents one of the most important innovations in the scientific field; born as an intelligent union between Buddhist tradition and psychology.
Have you ever had the experience of stopping completely,
of being so totally in your body,
of being so totally in your life
that what you already knew and what you don’t know,
and what has been and what is yet to be,
and things as they are right now
don’t give you even a thread of anxiety or disagreement?
It would be a moment of total presence,
beyond struggle, beyond mere acceptance,
beyond the desire to escape or fix things or dive headfirst into them:
a moment of pure being, outside of time,
a moment of pure sight, pure perception,
a moment in which life simply is,
and that “being” takes you, grabs you with all your senses,
all your memories, right into your genes,
in what you love most,
and tells you: welcome home.
(Jon Kabat-Zinn)
This possibility of simply being with what happens outside and inside us has great transformative and therapeutic power. From this point of view, the most interesting aspect of mindfulness is that it can act directly on the relationship between the mind and its contents, without directly addressing the merit of the latter. It can be seen as a form of naturalistic observation, or participant observation, in which the objects of observation are the perceptible mental phenomena that normally present themselves during the state of conscious wakefulness.
Shapiro, Carlson, Astin, and Freedman (2006) argue that the mechanisms of Mindfulness consist of intention, attention, and a specific attitude, which together contribute, each in its own way, to a process that allows seeing things in a new way, a process the authors call re-perceiving. These and other authors recognize that Mindfulness can also have common outcomes, such as patience, non-reactivity, self-compassion, and wisdom. In Acceptance and Commitment Therapy (ACT).
Anyone can approach the practice of awareness and benefit from it: “the capacity to be aware is present in each of us, all that is needed is to cultivate attention to the present moment” (Kabat-Zinn). However, we can say that the practice of awareness is particularly recommended for the following problems:
Who mindfulness is for
Anyone can approach the practice of awareness and benefit from it: “the capacity to be aware is present in each of us, all that is needed is to cultivate attention to the present moment” (Kabat-Zinn).
However, we can say that the practice of awareness is particularly recommended for the following problems:
Anxiety disorders
People who present problems related to anxiety tend to perceive their internal sensations, thoughts, and emotions as dominant and invasive in a sort of complete identification with them: “I am my anxiety, my fear…” as well as towards specific situations they find themselves living that can be perceived as insurmountable and overwhelming obstacles. These distorted, and often catastrophic, evaluations of events and one’s internal contents (emotions and bodily sensations) trigger anxiety symptoms that are again interpreted catastrophically, thus triggering vicious circles that continuously maintain and feed anxiety states.
The practice of awareness facilitates the acquisition of a new way of relating to one’s internal experience, through a different relationship with catastrophic thoughts, physical sensations, and emotions experienced. In this way, people also manage to plan and implement appropriate behaviors for managing situations.
(STUDIES DEMONSTRATING EFFECTIVENESS FOR ANXIETY DISORDERS: ROEMER & ORSILLO, 2002; MILLER ET AL., 1995).
Prevention of relapses in depression
Within depression therapy, the practice of awareness plays an important role in reducing the possibility of relapsing into a depressive state.
Generally, most people who have suffered or suffer from depression can confirm how during the depressive period the mind is crowded with thoughts, emotions, images, and physical sensations that are all negative. Furthermore, these people, trying to understand their problems, as well as their inadequacies, mistakes, and poor self-worth, spend a good part of the time during the day continuously thinking about negative aspects, believing that, in this way, they can understand themselves better and discover how to solve their problems.
This modality is called “rumination” and consists of an uncontrollable chain of thoughts that is connected to negative emotions. Thinking it is a useful mechanism to escape suffering, people very often do not realize that this modality is actually counterproductive because it does not help to understand oneself better or solve problems but, on the contrary, ensures that, by continuing to ruminate on what is negative in oneself and on the problems of daily life, depression increases rather than decreases. This is what determines relapse into depressive states: even just experiencing an emotional state of sadness, one tends to start thinking negatively again and spend a lot of time ruminating on negative thoughts.
In awareness practice groups, the patient has the opportunity to change the way they relate to their thoughts, in the following way: identifying negative thoughts when they present themselves; beginning to see thoughts from a new perspective, that is, simply as thoughts, and not as reality; learning to identify signs of relapse into depression and manage them.
(SEGAL, WILLIAMS AND TEASDALE, 2002)
Personality disorders
Patients with personality disorders, when faced with stressful, anxiety-provoking, or frustrating events, tend to react to the unpleasant moods with which they experience such events, to the particularly intense emotions they may feel, and to physical sensations considered unbearable, by implementing impulsive behaviors (such as, for example, alcohol abuse, binge eating, etc.) or strong avoidance of situations that cause stress. Both impulsive behaviors and avoidance behaviors result in cancellation or, at least, a reduction of internal distress and for this reason continue to be used.
The practice of awareness, in this case, helps patients learn how to live an unpleasant emotional experience in the present, without having to immediately interrupt it through recourse to impulsive behaviors and avoidance.
(LINEHAN, 1993)
Borderline personality disorder
As with other personality disorders, mindfulness also plays an important role in borderline personality disorder in increasing awareness of the present moment and creating the possibility of not immediately reacting with impulsive behaviors. Furthermore, for this disorder, the practice of awareness is particularly indicated for several reasons.
First, it helps people adopt a non-judgmental attitude towards themselves and others, allowing them to cope with their natural tendency to make extreme judgments about themselves and others, both in excessively positive and negative terms.
Second, it helps focus one’s attention on one task at a time and engage in it with presence, clarity, and conviction, compensating for these people’s difficulty in setting aside their problems to concentrate on the activity they are performing, often distracted by thoughts and images from the past, worries about the future, ruminations on problems, or negative moods. Finally, it facilitates the person’s abandonment of the search for what is “right” or “wrong” to have, instead, more confidence in their perceptions, judgments, and decisions.
Stress and chronic pain
Suffering from a chronic illness or disability, as well as being subjected to more or less heavy situations, can introduce an important dose of stress into one’s life, from which it is not always possible to escape. Often physical pain, stress, the discouragement that follows, and suffering in general are faced through forms of avoidance and attempts to eliminate problems, which do nothing but magnify them and increase stress.
The practice of awareness offers, instead, a different way of relating to pain and stress, which consists of living every moment of life as important, as something that counts and to be used to move forward, even moments of pain, sadness, despair, or fear. Rather than fighting against a reality that is unchangeable, the practice of awareness proposes learning to fully live every moment of one’s existence, beautiful or ugly as it may be, finding within oneself that source of internal energy to draw upon to cope with stress.
Studies have been conducted in which mindfulness programs have proven effective for: post-traumatic stress disorder: Follette et al., 2004; Foa et al., 2000; Chronic Pain: Kabat-Zinn, 1982; Kabat-Zinn et al., 1987; Fibromyalgia: Kaplan et al., 1993; Singh et al., 1998; Epilepsy: Deepak et al., 1994; Psoriasis: Kabat-Zinn, 2003; Brain Trauma: Bedard et al., 2003; Insomnia: Lundh, 2005.
Eating disorders
Over the past few years, various studies have been conducted on the benefits of awareness meditation practice within some treatment programs for eating disorders. Various studies (Telch, 2000, 2001; Baer, Heffner, 2002) demonstrate the effectiveness of mindfulness programs for resolving binge eating, as people learned to recognize and observe their emotions and thus regulate negative emotions without resorting to food.
